J Adv Prosthodont.  2010 Sep;2(3):106-110. 10.4047/jap.2010.2.3.106.

Full mouth rehabilitation of the patient with severely worn dentition: a case report

• Song MY
• Park JM
• Park EJ

• KMID: 2118116
• DOI: http://doi.org/10.4047/jap.2010.2.3.106

Abstract

The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and the permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function.

Keyword

Tooth wear; Vertical dimension of occlusion; Occlusal overlay splint

MeSH Terms

Aged
Dental Occlusion
Dentition
Esthetics
Female
Humans
Mouth
Mouth Rehabilitation
Splints
Tooth
Tooth Wear
Vertical Dimension

Figure

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  Fig. 1 Initial oral examination. A: Frontal view. Severely worn dentition and loss of posterior support were shown. B: Maxillary occlusal view. The palatal surface of maxilliary left canine was worn to the gingival level and got root canal treatment. C: Mandibular occlusal view. The severe attrition and abfraction on anterior teeth were shown.

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  Fig. 2 Transcranial view of TMJ. Disfigurement or limitation of movement of TMJ was not detected.

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  Fig. 3 Occlusal overlay splint was delivered and monitored for 1 month to evaluate patient's adaptation to the new VDO.

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  Fig. 4 Diagnostic wax-up was done on the new VDO that was obtained by adjustment using the overlay occlusal splint.

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  Fig. 5 Provisional restorations were placed after trial period of removable occlusal overlay splint.

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  Fig. 6 Customized anterior guide was made utilizing the duplicated provisional restoration casts.

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  Fig. 7 Bite registration was taken using provisional restoration and bite registration material by half and half. A: Left bite registration, B: Right bite registration.

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  Fig. 8 Definitive restoration was delivered. A: frontal view, B: maxilliary occlusal view, C: mandibular occlusal view.

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